Medical Adventures in Samoa

by Maggie Doolan

Maggie Doolan is a past graduate of The School of Total Education. Maggie joined the School in preschool and graduating in 2011. Maggie went on to study biomedical science and is now in her second year of medicine at the University of Queensland. Maggie recently did her clinical placement as a first year medical student in American Samoa and she has been gracious enough to share her experience.

At the end of our first year of med school, UQ students are required to do
a clinical placement at a hospital or medical practice. My med student
friend has family in American Samoa so we thought we would make the most
of that connection and get some insight into a contrasting heath care system.
(That just happened to be on a beautiful tropical island!)

The hospital where I did my placement was funded by the US government which
meant that it was completely flooded with patients from surrounding islands
who would come to take advantage of a free health service. The Hospital
was understaffed and many of the doctors were burnt out. Nonetheless they
were extremely welcoming to students like me. I flitted around to different
specialties and wards hoping not to burden one doctor for too long at a
time. I tagged along during ward rounds, scrubbed into some spectacular
surgeries and when things were quiet I would go and sit with the babies
in the neonatal care unit.

American culture has had perhaps its most striking influence on the local diet.
Traditionally, the Samoan diet consists of fresh seafood, starchy foods
like breadfruit, taro and plantains as well as an abundance of tropical
fruits and coconuts. Now there are convenience stores brimming with processed
foods and McDonalds is buzzing with school kids. As you can imagine, this
has profound implications for the health of the Samoans. Obesity related
diseased such as diabetes, heart disease and stroke are common.

Compared to the Australian healthcare system, there is a lack of preventative
health care in Samoa. There is also a stoicism amongst the islanders resulting
in a cultural reluctance to go to the doctor. This meant that when patients
did finally present to the hospital things had already deteriorated so
severely that treatment was just about damage control. It was really tragic
to see these potentially manageable conditions like diabetes spiral out
of control so that the patient had to endure recurrent skin infections
or limb amputations. It highlighted to me the important role of primary
healthcare providers such as GPs.

Its such a gem of an island so we made the most of our time outside of hospital
hours to explore. After work we could cool off in the waterfall behind
of the hospital or swim at one of the beautiful beaches. My friend’s Grandma
who we were staying with was extremely strict so every day we went exploring
we told her we were just going to the same beach near our house. I think
she got a bit suspicious when we came back from climbing the highest mountain
on the island covered in sweat and mud…

I felt so cared for a welcomed in Samoa. Neighbours gifted us with coconuts,
pineapples and avocados, drivers passing us by offered us lifts home and
new friends took us in their boats to untouched islands that would have
been inaccessible as a tourist. The doctors I shadowed were generous in
sharing their time and knowledge. I was especially grateful to the patients
who at their most sick and vulnerable, still shared their stories with
me so that I could learn. I was so touched by the generosity I was shown
and I hope to be able to practise the same generosity as a doctor and as
a person.